AccountId: 011433970860
ContactId: ed674bb9-e7f9-4b5a-bcf6-447d4701a9b5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1048719 ms
Total Talk Time (AGENT): 387449 ms
Total Talk Time (CUSTOMER): 370387 ms
Interruptions: 2
Overall Sentiment: AGENT=0, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/ed674bb9-e7f9-4b5a-bcf6-447d4701a9b5_20250609T14:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII] in [PII]. How's everything?
[AGENT][POSITIVE] Good, how are you?
[CUSTOMER][POSITIVE] Doing great, doing great just calling to check on 2 claims for 2 of our customers if you don't mind.
[AGENT][NEUTRAL] Sure I can help you with claim status. Um, are you a broker?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, give me just one moment.
[AGENT][NEUTRAL] Uh, can I get a callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] And what's the first policy number?
[CUSTOMER][NEUTRAL] It is 225293-1.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] And [PII], can I get you to verify your email address for me?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK. And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have the date of service?
[CUSTOMER][NEUTRAL] And ever since this new system,
[AGENT][NEUTRAL] Oh, go ahead.
[CUSTOMER][NEUTRAL] Sorry, uh, [PII]. This new system coming out, I know it's had a lot of hiccups, but the main problem I'm seeing is I can't see my past claims that I've uploaded for people.
[AGENT][POSITIVE] OK, uh, let me look into that. Let me look for his, um, date of service real quick and I can get you the claim status and then we can try and troubleshoot that or I can send you to broker resources and see if they can troubleshoot that. Uh, we'll try and get it all done in the same phone call. You're all right with that.
[CUSTOMER][POSITIVE] Sure, thank you.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's what it said as as the date of diagnosis.
[AGENT][NEGATIVE] Computer's going a little slow. Give me just a second.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][POSITIVE] Good
[CUSTOMER][NEUTRAL] I feel like I'm running blind here and normally I can pull up everybody who has an existing claim. I could see everything I've uploaded. I can see status, um, but with the new system it's um it's just set up different.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And normally
[CUSTOMER][NEUTRAL] I've seen it with a bunch of companies um, whenever there's a new system that comes out, it does some things better and some things worse unfortunately, you know.
[AGENT][NEUTRAL] Yeah, it's hard to get the perfect system going.
[AGENT][NEUTRAL] Alright, let me see here.
[AGENT][NEUTRAL] It looks like that claim.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] We did process it. However, in order to provide further consideration for the claim, we will need the itemized bill for treatment received and medical records for the date of service of [PII], and it looks like it's the same for date of service of [PII]. They were they were put on the same claim.
[CUSTOMER][NEUTRAL] OK, like right now I'm looking online, like under his under him and I'm click on claims and it says no claims available, no open claims.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And it's like that for everybody that I pull up who has claims and open claims.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But at least I know that for this, um, so we need.
[CUSTOMER][NEUTRAL] Itemized copy of the bill from either the [PII] or [PII] whenever he was in the hospital with a heart attack, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, the itemized bill and then any sort of medical records.
[CUSTOMER][NEUTRAL] OK, itemized bill and medical records, so I'll have to get him to log into his portal or reach out to the.
[CUSTOMER][NEUTRAL] The hospital, OK, so I'll get with him.
[AGENT][NEUTRAL] Right, and they should they could send it on his behalf too if that makes it quicker um.
[AGENT][NEUTRAL] Do you have our our our uh fax number in case they can they could just fax it over on his behalf?
[CUSTOMER][NEUTRAL] No, let me write that down.
[CUSTOMER][NEUTRAL] I know that I have that one second.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] Our fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the claim number for the data service you mentioned is 360.
[AGENT][NEUTRAL] 8084.
[CUSTOMER][NEUTRAL] 3608084
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Got it. OK, I'm gonna go get with him and um.
[AGENT][NEUTRAL] And was your
[CUSTOMER][NEUTRAL] There there was another person. Let me see. The problem is is that
[CUSTOMER][NEUTRAL] APL's been doing this thing where if a person is.
[CUSTOMER][NEUTRAL] Termed from one of our groups.
[CUSTOMER][NEUTRAL] They're taking them out the system even if they export their coverage. So this person still has coverage but I can't pull them up in my system to give you like a date of birth or something. So, but I can tell you, let's go take a look.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Can I give you a policy number?
[AGENT][NEUTRAL] Yes, give me just one moment, um, so I can uh finish the notes on this one. No, you're OK?
[CUSTOMER][NEUTRAL] OK, I'm sorry, go ahead.
[AGENT][NEUTRAL] Computer's being a little iffy, so give me just a moment.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] Right, and what is the other claim number, or I'm sorry, uh, policy number?
[CUSTOMER][NEUTRAL] The policy number on this one is 2258955.
[AGENT][NEUTRAL] Alright, give me just a second.
[AGENT][NEUTRAL] And patient's oh, and you said you don't have the patient's name or date of birth for that?
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] It's, it's [PII] and it's on his wife [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He worked for Gulfstream Services.
[CUSTOMER][NEUTRAL] And they termed him, but he's keeping his coverage.
[CUSTOMER][NEUTRAL] But he has a claim on file.
[AGENT][NEUTRAL] Do you happen to have, oh, so you're not able to give anything other than his name? You don't have social or anything like that, correct?
[CUSTOMER][NEUTRAL] Well, [PII] took him out of the system even though he's not lapsed.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me see about that.
[AGENT][NEUTRAL] And what we can do.
[CUSTOMER][NEGATIVE] Which is a bad, which is a bad habit because they do that and people's coverage is still active. You see what I'm saying?
[AGENT][NEUTRAL] Yeah, cause I am seeing that.
[CUSTOMER][NEUTRAL] So they can't take it out of our purview is a is a bad deal because I can't help but certain things that are important to the people even though they kept their coverage.
[AGENT][NEUTRAL] Let me
[CUSTOMER][POSITIVE] It's just little small things that um that they could fix that would make our life easier, you know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] And I'm not even able to get a customer number on him to look it up.
[CUSTOMER][NEUTRAL] Let me see, let me go look at.
[CUSTOMER][NEUTRAL] I have so many folders here but I have.
[CUSTOMER][NEUTRAL] I keep everybody's everybody sends me a ton of stuff for claims.
[AGENT][NEUTRAL] Oh yeah, I bet.
[CUSTOMER][NEUTRAL] And I have um.
[CUSTOMER][NEUTRAL] It's just a lot, yeah.
[CUSTOMER][NEUTRAL] Just checking my spot real quick here for you. I don't wanna hold you up.
[AGENT][NEUTRAL] Oh, that's OK.
[AGENT][NEUTRAL] And I'll also whenever I transfer you to broker resources to try and get your OSC um working properly, I'll also mention this to them too that um you're not able to pull them up and you're not able to pull Sunny up in the system and I don't have a customer number to look them up either so they might be able to help with that. Oh there it is.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me try this.
[CUSTOMER][NEUTRAL] Let me see here I'm I'm, I have some stuff right here. I might have her.
[AGENT][NEUTRAL] OK, I was able to find the customer number. Alright, yeah.
[CUSTOMER][NEUTRAL] 22,870.
[AGENT][POSITIVE] That works, yeah, I was able to pull them up. They don't have an OSC account so I wasn't able to pull up much more.
[AGENT][NEUTRAL] And that, um, what was the date of service for this one?
[CUSTOMER][NEUTRAL] Um, it looks like.
[CUSTOMER][NEUTRAL] [PII], that's what's on this um surgery report.
[AGENT][NEUTRAL] Alright, let me look.
[AGENT][NEUTRAL] And was it the hospital indemnity policies that they put it under, do you know? Or does it say?
[CUSTOMER][NEUTRAL] Yes, yes, yes, it was an outpatient surgery.
[AGENT][NEUTRAL] Because I don't have any files for them after [PII].
[AGENT][NEUTRAL] It looks like, let me see.
[CUSTOMER][NEUTRAL] No, I had to email these to the home office because they removed them from the OSC.
[CUSTOMER][NEGATIVE] They're acting like they don't have it.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Because the last thing I'm seeing on here is from [PII]. Um, let me
[AGENT][NEUTRAL] Let me get you to broker resources and let them um work on your OSC account and then for this one we might need to have is it alright if I have uh.
[AGENT][NEUTRAL] The claims support call you back or uh I can have the broker resources transfer you afterwards too, but just in case they're busy.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, we'll work on that one too because I'm not, yeah, I'm not seeing anything past [PII].
[CUSTOMER][NEGATIVE] That's not good.
[AGENT][NEUTRAL] Yeah, OK. Give me just one second. Um, I'll talk to broker resources, let them know kind of, uh, what's going on. They might be able to help you with this one too, but if not, we'll get you, we'll get claim support to look into it as well.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, give me just one moment.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[AGENT][NEUTRAL] Hi [PII], I have broker [PII] on the line. Um, he's calling for two different reasons. Um, I, I think you'll be able to help him with the first one, and then we'll need to you'll probably have to transfer him to cus uh claim support for the second one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] He's got a lot of, he's got a lot of stuff going on. He's having issues with his OSC account, um.
[CUSTOMER][POSITIVE] OK, no problem.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] I can give you
[CUSTOMER][NEUTRAL] What's his last, did he give you his full name?
[AGENT][NEGATIVE] Yeah, and I'm not even gonna try it. [PII], I wrote it down as [PII] and clearly that was not it.
[CUSTOMER][NEUTRAL] OK, it's OK.
[CUSTOMER][NEUTRAL] Uh, [PII], I think I, I think I talked, I think I talked to him the other day, so, OK, yeah, I think I talked to him the other day. OK, he's
[AGENT][NEUTRAL] Yeah, he's saying he's not able to see any of his claims or anything in the OSC and he's having issues with that, so that's the thing that I think you'll be able to help him with um and if not I'm just supposed to send them to you anyways. Then the second one is for um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] Uh, oh my [PII], I just lost my train of thought for policy number 2,258,950.
[CUSTOMER][NEUTRAL] They claim
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] 25.
[AGENT][NEGATIVE] They are reporting their policy. They have not lapsed yet, but I'm only seeing claims. The last claim was reported in [PII]. He gave me a claim. He said he emailed us the claim and it was for [PII] and he said they should have more claims than just from [PII], um, and we're not able to look them up. He's not able to look them up because they took them out of the OSC, um, even though they're reporting their policy and.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Um, I mean, it's still effective.
[CUSTOMER][NEUTRAL] Yeah, we haven't taken him out. He just can't see it. Yeah, he just can't see it in his new new environment probably, and he can't access the old environments, but so you did you see any claims? Are you, can you see claims under that?
[AGENT][NEUTRAL] Um, I only see, I see claims for the second one that he gave me, but the last one was [PII]. He submitted, he's like there's, there should be more than that. Um, I don't know if it went under.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] OK, and you don't see any other claims out there for that person.
[AGENT][NEUTRAL] Yeah, and, and I'm not seeing any either, and he said he filled one in for emailed one or something uh for the data service of 5125 so I feel like that's where claim support might be needed to do some research on that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm, yeah, that'll be on the claims side for sure unless well it's possible he sent it to our side and we just need to figure out if we have it on our side. So, OK, perfect. I will talk to him [PII] I think his name or something like that.
[AGENT][NEUTRAL] Yeah, right, and he's verified, he's verified all the other things. Uh, he's good to go. Do you need his callback number?
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[CUSTOMER][NEUTRAL] Uh, yeah, just in case.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII] OK perfect thank you.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Give me just one moment.
[CUSTOMER][NEUTRAL] Hi, is this [PII]? Oh, sorry.
[AGENT][NEUTRAL] Oh hold on one moment. I had to find my mouse first. All right, here we are.
[CUSTOMER][NEUTRAL] You're fine.
[CUSTOMER][POSITIVE] I got you, I got you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hi [PII] we have broker resources on the line for you.
[CUSTOMER][NEUTRAL] Hi [PII].
[CUSTOMER][POSITIVE] Great, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Hey [PII]. Hi [PII], this is [PII]. She said you can't see anything under your account or some things you can't see and can't see. Good. Yes ma'am.
[CUSTOMER][NEUTRAL] Let's see, hold on one second, let me close this out. I'm sorry. You're fine you're in the middle of a.
[CUSTOMER][NEUTRAL] Email to the home office. OK, so basically the long and the short is I know there's been some ups and downs with the new OSC, but my, my issue we're having is when we go in all the existing claims that were uploaded before are gone so everybody we pull up in the system, none of their stuff is there.
[CUSTOMER][NEUTRAL] So where what are you, are you logging in under your personal broker account or are you logging in into the agency account when you can't see a when you can't see the groups I'm trying I'm trying to. OK. Mm this is under the one that all my groups are listed under so the one that actually has all the groups under it and all the employees when I go in to pull up their claims, there's nothing in the history for every person that I pull up.
[CUSTOMER][NEUTRAL] So did all the prior claims information come over when y'all switch to the new one?
[CUSTOMER][NEUTRAL] Well it's supposed to, but I think there's an issue with you. I'm not sure because they're trying to troubleshoot all this but it seems like if you're under.